Organization
MONTGOMERY DRUG CO INC
Active
Other names
MONTGOMERY DRUG COMPANY
Organization subpart
No
Provider details
NPI number
Authorized official
JAMES RANDLE RPH (COOWNER/PHARMACIST)
(662) 489-5555
Entity
Organization
Contact information
Practice address
349 HIGHWAY 15 N, PONTOTOC, MS 38863-1105
(662) 489-5555
(662) 489-6759
Mailing address
349 HIGHWAY 15 N, PONTOTOC, MS 38863-1105
(662) 489-5555
(662) 489-6759
Taxonomy
Speciality
Code
Description
License number
State
333600000X
Pharmacy
—
—
3336C0003X
Community/Retail Pharmacy
Primary
01025/1.1
MS
3336L0003X
Long Term Care Pharmacy
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00093700
—
MS
01
—
2044591
PK
—
Enumeration date
07/30/2006
Last updated
04/29/2016
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